Empower Your Healthcare Sales Team with a Sales Performance Management System for Healthcare

How to create outlook signature

hello and welcome to topic for this is dr. Hancock and I'm happy to give you an overview this week of your content which is going to cover management challenges in healthcare there's four outcomes which you should accomplish in this week's module the first is that you'll be able to explain the four most important Hospital strategies for value-based payment implementation second you'll be able to articulate major challenges affecting healthcare organizations in the contemporary environment third you'll be able to synthesize ways as a manager to promote patient value while achieving quality safety and cost effectiveness and fourth you'll identify and use performance measurement methods if you have been Lazare and done him tailored textbook you'll read chapter four and if you have Baker Baker and Dworkin you're read chapter 27 the content on these slides comes from both the textbooks and other resources that I've pulled together for you Lazare tailor define the top four challenges in contemporary healthcare as those on this slide chapter four of their textbook spends a good about a time discussing how healthcare providers can discover what patients really want in value historically health decisions have been very paternalistic and driven by physicians doctors have simply told patients what must be done and patients were expected to obey this has resulted in terms like compliance and non-compliance with doctor's orders today's patients may prefer to be active participants in their own care the idea of informed consent has shifted to become shared decision-making between patients and their care providers this means we cannot assume all patients want the same outcomes and there has to be an ongoing effort to identify patient wants and values at both the individual and system levels quality in healthcare means different things to for people most of our standard definitions have ignored patient wants and values and instead they focused on the perspective of healthcare professionals or regulators we tend to measure quality by performance on technical standards in healthcare we look at things like readmission rates hospital acquired infection rates length of stay and the number of procedures performed these are examples of some technical standards these types of quality measures used in most Hospital reporting systems although we are beginning to see things like patient satisfaction scores as equally as important the third challenge here after patient wants and values and quality is to keep the patient safe this seems like a no-brainer safety means that no patient should be injured or become ill as a result of their health care experience the final challenge in healthcare and perhaps our biggest one is to accomplish these first three items in a cost-effective way we need to provide safe quality care in ance with what our patients want and value and control costs our healthcare organizations and managers are struggling with this one in previous modules you explored the performance of the US healthcare system and some of its problems overall we looked at the fact that the u.s. spends more per capita than any other country yet yields through third world outcomes when you look at things like mortality and morbidity rates our care is often fragmented and depersonalized an unintentional harm to patients is common with both medication errors and other types of illnesses and injuries that result from the patient being in our healthcare system patient needs in values that we just talked about are often not considered in plans of care to illustrate these concepts and particularly that of fragmented and D personalized care I encourage you to read a personal story from sue Haas Miller of the Robert Wood Johnson Foundation I've posted her story on canvas and it's where she speaks of being a family member in the hospital system when her husband was in critical care it gives you a good first-person view into some of these problems how can we do better creating a better future health care system requires leadership planning and change management in 2011 the American Hospital Association recommended 10 must-do strategies for hospitals to prepare for a future consumer driven value-based marketplace these strategies are outlined in a report called hospitals and care systems of the future these four are identified as the most important hospital strategies for value-based payment implementation other types of healthcare organizations can also benefit from prioritizing these strategies the first priority addresses the need for seamless patient care across the continuum too often if you work in a single setting like a hospital or a home health care or a clinic you don't necessarily consider what your patient has done before they arrived in your facility or what's going to happen to them afterwards we all need to more proactively address how we can care for our patients no matter what setting they're in the second priority set forth by the American Hospital Association proclaims the use of evidence-based practice to improve quality and safety the third priority is improved efficiency it's well known that unnecessary operational inefficiency is a significant source of health care costs improved efficiency will help reduce costs and also to decrease more timely care to increase care that is timely to the patient the final top priority for hospitals in preparation for the value-based market is to develop integrated information systems technological advances have contributed significantly to the increasing cost of our healthcare but it is evident that data have to be readily available for analysis and improvement work how do patients and health care providers know what quality means in health care one framework that we can use to explain and educate our patients about quality is the Institute of Medicine or IOM domains of improvement the domains of improvement allow you to lump healthcare initiatives and outcomes into domains that are easily explained and then can be shared internally and with patients and their families the six domains of improvement suggested by the Institute of Medicine are safe healthcare should avoid harm to patients from care that is intended to help them should be effective providing services based on scientific knowledge to all who could benefit and refraining from providing services to those who are not likely to benefit effective care avoids under use and misuse of healthcare services patient-centered this means providing care that is respectful of and responsive to individual patient preferences needs and values and ensuring that patient values Glyde all of our clinical decisions timely reducing weights and sometimes harmful delays for both those who receive and those who give care efficient avoiding waste including waste of equipment supplies ideas and energy and equitable equitable care means care that does not vary in quality because of personal characteristics such as gender ethnicity geographic location or socioeconomic status frameworks like these IOM domains make it easier for patients to grasp meaning and the relevance of quality measures studies have shown that providing people with the framework for understanding quality helps them value a broader range of quality indicators when technical performance measures are grouped into these user-friendly domains patients can see the meaning of the measures and how it more clearly relates to their own concerns about their care quality improvement and healthcare redesign are critical for our nation's health and well-being as well as for our financial solvency the IOM proposed ten fundamental rules for managers to follow when redesigning healthcare delivery in organisations and communities these rules are important to keep in mind in all your management decisions care should be based on continuous healing relationships patient should receive care whenever they need it and in many forms not just your face-to-face visits the health care system should be responsive at all times and access to care should be provided of the internet by telephone and by other means in addition to face-to-face visits care should be customized based on the patient's needs and values the system of care should be designed to meet the most common needs but should also have the flexibility to respond to an individual patients choices and preferences patients should be in control patients should be given necessary information and the opportunity to exercise as much control as they choose over the health care decisions that affect them the health system should be able to accommodate differences in patient preferences and should encourage shared decision-making the system should encourage shared knowledge and the free flow of information patients should have unfettered access to their own information and to clinical information clinicians and patients should communicate effectively and share information decision-making should be evidence-based this means patients should receive based on the best available scientific knowledge care should not vary illogically from clinician to clinician or from place to place safety should be a property of the system patients should be safe from injury caused by the care system reducing risk and ensuring safety will require systems that help prevent and mitigate errors the system should be transparent the health care system should make information available to patients and their families that allows them to make informed decisions when selecting a health plan a hospital a clinical practice or when choosing among alternative treatments patients should be informed in the systems of the system's performance on safety evidence-based practice and patient satisfaction the system should anticipate patient means it should be proactive not reactive the system should constantly strive to decrease waste the health care system should not waste resources or our patients time and finally the health care system should encourage cooperation among clinicians clinicians and institutions should actively collaborate and communicate with each other to ensure that patients receive appropriate care these rules came out in 2001 so it's been 16 years how are we doing when I look at these rules it seems to me that we still have quite a long ways to go since 2001 10 more rules were suggested by the Institute for Healthcare Improvement the IHI leadership alliance this is a group of around 40 health care organizations who are committed to achieving care better than we've ever seen health better than we've ever known and at a cost we can all afford in the first year of their alliance they reviewed the ten simple rules promoted by the Institute of Medicine for redesigning the health care system and they asked themselves what new rules do we need now to address our current set of challenges in health care even though we haven't necessarily solved all the old ones as a result they developed guiding principles for health care transformation which they call the ten new rules for radical redesign in healthcare here are the rules they propose first change the balance of power co-produce health and well-being in partnership with patients families and communities number two standardize what makes sense standardize what is possible to reduce unnecessary variation and increase the time available for individualized care three customized care to the individual contextualized care to an individual patients needs values and preference guided by an understanding of what matters to the person in addition to what's the medical problem 4 promote well-being focus on outcomes that matter the most people appreciating that their health and happiness may not require health care at all this is much like the change in psychology where they've now promote positive psychology instead of looking at diagnosis of what's wrong number 5 create joy in work cultivate and mobilize the pride and joy of the healthcare workforce it's interesting isn't it that previous rules didn't really seem to care about the workforce at all but as of 2015 healthcare leaders are recognizing that the healthcare workforce is an integral part of healthcare services and that joy in our work matters and actually improves the care we provide number six make it easy continually reduce waste and all non-value-added requirements and activities for patients families and clinicians 7 move knowledge not people exploit all helpful capacities of modern digital care and continually substitute better alternatives for visits and in to tional stays meet people where there are literally for some of us that means being able to call or email our phone our providers using our smartphones or to look up rad lab results online for many people technologies a great solution but not for everybody especially in some of our rural areas and older patients they may not have the internet access or the capability of managing those systems so we still have to meet everyone where they are number-8 collaborate and communicate recognize that the healthcare system is embedded in a network that extends beyond walls eliminate silos within healthcare and tear down self protective institutional or professional boundaries that impede flow and responsiveness to the patient number 9 assume abundance use all the assets that can help to optimize the social economic and physical environment especially the assets that are brought by patients their families and their communities and number 10 return the money return the money from healthcare savings to other public and private purposes I have to admit I like these 10 new rules a lot although when I look at healthcare facilities in my area it seems we have a very long way to go to truly put all of these rules into practice it's a big challenge that I'm throwing to you all as future health care managers we're gonna shift gears now for a minute and talk specifically about performance management systems performance management first became popular in health care in the 1990s it started when employers shopped for health plans to offer their employees employers wanted to examine cost and quality data to see which health plan was best for their dollar spent then later the concept of performance management spread into health care organizations and they started developing their own in-house report cards in order to improve their services in recent years there's been a rapidly growing interest in performance and quality improvement within healthcare different names and labels are often used to describe similar concepts or activities other sectors like industry and hospitals have embraced a diverse and evolving set of terms but which generally have the same principles at heart getting better over time so things you hear like continuous quality improvement quality improvement performance improvement quality management performance measurement Six Sigma total quality management they all generally mean gathering data and analyzing the data to improve performance over time the basic idea behind performance management systems in healthcare is that patient outcomes can be used to determine whether the organization is performing effectively although this practice is better than in the past when patient outcomes were not tracked at all it still has its flaws the first is that you cannot predict future performance based on history the number of infection rates in a hospital last year for example certainly does not determine the number of infections they're going to have this year performance management systems typically do not include patient wants and values in their data as we've already talked about some organizations are actually drowning in data they collect lots of information on everything but they don't have the time or the resources to analyze it to determine what's important or how to use it another problem is that in many cases data has only been used to document problems that result in negative consequences or punishment instead of using the data to celebrate success or to plan for future improvement as organizations begin to collect more data the Joint Commission an accreditation agency for hospitals expanded their prefer performance measurement rules which you may know as the Joint Commission core and non-core measures the Centers for Medicare and Medicaid Services or CMS also begin requiring certain datasets from hospitals long-term care agencies and home health care information about how health care organizations perform on these core and non-core measures is now available online to the public the CMS was the first agency to provide performance reports to the public so that patients can literally compare hospitals physicians nursing homes and home health agencies today there are a number of other public and private sources of healthcare performance information I've posted a link for you to the Robert Wood Johnson foundations resource which is called comparing health care quality this is a national directory of resources where you can look at performance indicators from health care providers and organizations some of it is national level some of it is state level I encourage you to check out the website and see what's available for your community as you've learned once healthcare organizations started reporting data on outcomes to the CMS it wasn't long before the CMS started to use that data to institute pay for performance or value based programs the goal is to reward providers who meet or exceed expectations and to punish those who do not by withholding or restricting dollars what CMS does is very important because CMS represents more than 50% of health insurance in this country including the Medicare and Medicaid systems CMS has been a leader in requiring health care agencies to report health outcomes and to tie reimbursement to performance private insurance companies are now beginning to follow suit health care organizations collect data to comply with regulatory requirements but they also collect and use data for internal reasons as we've discussed when we were talking about performance measurement one concept that I wanted to introduce to you is that the balanced scorecard the balanced scorecard is a strategic planning and measurement and management system that many organizations use in order to communicate what they're trying to accomplish align the day-to-day work that everyone is doing with the overall business strategy and to prioritize projects products and services they also use the balanced scorecard to measure and monitor the organization's progress towards its strategic long-term goals I've posted a full explanation of balanced scorecards and how they work with some templates on canvas and you should read it to fully accomplish the outcomes in this module the balanced scorecard system essentially connects the dots between big picture strategy like an organization's mission vision and values with operations the operational measures are things like objectives measures which are also called key performance indicators targets the desired level of performance and initiatives which are the projects that help you meet your targets the balanced scorecard suggest that we view the organization from four perspectives and to develop objectives measures targets and initiatives relative to each one of these four points of view the first point of view is financial and sometimes you'll also see that called stewardship stewardship this financial perspective views the organization's financial performance and their use of financial resources another perspective is that of the customer sometimes called the stakeholder this perspective views organizational performance from the point of view of the customer that the organization is designed to serve in healthcare that's typically going to be our patients although we sometimes would call them residents or other names another perspective is that of the inter process this is a way to look at organizational performance through the lens of quality and efficiency related to our products and services or other key business processes and then the final perspective is often called learning and growing and this is a view of organizational performance through the lens of its people or human capital the infrastructure technology culture and other capacities that are the key to breakthroughs in employee performance among each of these four perspectives you'll see objectives measures targets and initiatives objectives are the continuous improvement activities that we have to do to implement strategy they break down more abstract concepts like mission and vision into actionable steps an example of an objective might be increased revenue or improve patient satisfaction for each objective on the strategy map at least one measure or key performance indicator will be identified and tracked over time measures indicate progress toward a desirable outcome strategic measures monitor the implementation and effectiveness of an organization strategies and they determine the gap between actual performance and targeted performance and that then helps us to determine organizational effectiveness and operational efficiency good measures or KPIs provide us with an objective way to see if our strategy's working they also offer comparison data to measure the degree of performance change over time they focus employees attention on what matters most of success and they allow us to measure our accomplishments targets are the goals or the benchmarks that we compare our measurable outcomes with one way that organizations track measurements and compare with targets is to use run and control charts and so in this week's practice exercise you're going to learn more about run chart and how to use them you're gonna be diving into management challenges this week in order to be successful and accomplish your outcomes I encourage you to start by reading the textbook chapters that are assigned and then go item-by-item through the materials I've posted in canvas lessons I have a personal story from soo Hass Miller that will let you kind of see what health care is like from a patient and family perspective I have posted for you a Maya clinic model for running a value improvement program to give you a sense of how performance management systems can work in the hospital I've shared with you the Robert Wood Johnson Foundation database comparing health care quality and then I've posted additional learning materials to help you learn how to use balanced scorecards and run charts and so in your assignment sections you have two key assignments for the week in the group discussion you'll start by exploring a case study from the Commonwealth Fund and you'll talk about how that case study fits into the content related to management challenges and then your practice exercise this week we'll be making a run chart using Microsoft Excel good luck get started early and if you run into any problems please email me or check in with your classmates to see how we can help you I hope you have a wonderful week